A physical therapist is evaluating a 55-year-old male patien…

A physical therapist is evaluating a 55-year-old male patient that presents with bilateral hand weakness.  The patient reports that he is having difficulty with gripping things around the house.  On examination, the therapist notes a (-) Phalen’s test, (-) Reverse Phalen’s Test, (-) Tinel’s Test.  On further examination, the therapist notes (+) Hoffman’s Sign, (+) Inverted Supinator Sign, and (+) Babinski Test.  Which of the following is the most likely cause of these symptoms?